. "5 PRIMARY HIV-PREVENTION STRATEGIES." Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioral Sciences. Washington, DC: The National Academies Press, 1996.
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Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioral Sciences
TABLE 5-2 Objectives of HIV-Prevention Programs Targeted to Men
Individual Behavior Change:
• Reduce the number of sexual partners.
• Reduce the frequent change of sexual partners.
• Learn to recognize STD symptoms, and seek early appropriate treatment.
• Accept and use condoms properly and consistently.
• Render condoms available, accessible, and affordable.
• Improve treatment of bacterial STDs.
• Change the social acceptability of multiple partners by men.
• Make STD treatment facilities accessible and affordable.
• Reduce the consumption of substances (alcohol) that enhance high-risk behavior.
• Promote public policies that enhance low-risk sexual behavior (e.g., condom-only brothels).
Types of Strategies and Programs
HIV-prevention strategies for men should aim to change individual sexual behavior, improve STD treatment services, provide condoms, change societal norms, and ease structural and environmental impediments to reducing risky behavior (Table 5-2). However, most programs targeted to African men to date have focused only on behavior-change interventions and the provision of condoms. The quality of the interventions varies widely. In some programs, only information services are offered; changes in behavior are not emphasized, and condom supply and availability are intermittent. In others, genuine attempts are made to change behavior; improve STD treatment; and make condoms readily available, accessible, and affordable by the target population (Mouli, 1992 ; Williams and Ray, 1993 [20-24]; Laga et al., 1994 ).
The following case study from Zaire illustrates a population-based intervention targeted to African men in which behavior change was promoted, and condoms were made available, easily accessible, and affordable.5
The Zaire AIDS Media and Condom Social Marketing Project was initiated in 1988 (Population Services International, 1992 ). The program developed specific messages targeted to youth aged 12 to 19 and young adults aged 20 to 30.
Throughout this chapter, we use case studies to illustrate representative intervention strategies, although few interventions have received rigorous evaluation.